Sotorasib
Pronunciation: so-to-ra-sib
Generic name: sotorasib
Brand name: Lumakras
Dosage form: oral tablets (120 mg, 240 mg, 320 mg)
Drug class: Miscellaneous antineoplastics
What is sotorasib?
Sotorasib is an oral targeted cancer treatment used to treat KRAS G12C-mutated non-small cell lung cancer (NSCLC) or colorectal cancer (CRC) in adults. It is a tablet that is taken once a day. The brand name is Lumakras.
Sotorasib works by targeting a specific cancer mutation called KRAS G12C that drives tumor growth. Its mechanism involves permanently attaching to this mutated protein, locking it in an "off" position so it can't signal cancer cells to multiply. This stops tumor growth and causes cancer cell death, but only in cells with this specific mutation, sparing healthy cells. In some colorectal cancers, combining sotorasib with drugs that block EGFR (another cancer pathway) works better than either treatment alone. Sotorasib is an inhibitor of the RAS GTPase family.
Sotorasib gained FDA approval on May 28, 2021, under the brand Lumakras. There is no generic
FDA approvals and indications
Sotorasib is FDA-approved to treat:
- KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC) as a single agent in adults who have received at least one prior systemic therapy
- This indication is approved under accelerated approval designation based on overall response rate (ORR) and duration of response (DOR). Continued approval may be contingent upon a continued clinical benefit being shown in confirmatory clinical trials
- KRAS G12C-mutated Metastatic Colorectal Cancer (mCRC) in combination with panitumumab, in adults who have previously received certain chemotherapy medicines (fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy)
Your healthcare provider will perform a test to make sure that sotorasib is right for you.
It is not known if sotorasib is safe and effective in children.
Side effects
The most common side effects of sotorasib when used alone for NSCLC are:
- diarrhea
- muscle or bone pain
- nausea
- tiredness
- cough
- changes in certain blood tests.
The most common side effects of sotorasib when used in combination with panitumumab for CRC are:
- skin rash
- dry skin
- diarrhea
- mouth sores
- tiredness
- muscle and bone pain
- changes in certain blood tests.
Serious side effects and warnings
Sotorasib may cause serious side effects, including:
- Liver problems. Abnormal liver blood tests are common with sotorasib and can sometimes be severe. Your healthcare provider should do blood tests before starting and during treatment with sotorasib to check your liver function. Tell your healthcare provider right away if you develop any signs or symptoms of liver problems, including:
- your skin or the white part of your eyes turns yellow (jaundice)
- dark or “tea-colored” urine
- light-colored stools (bowel movements)
- tiredness or weakness
- nausea or vomiting
- bleeding or bruising
- loss of appetite
- pain, aching, or tenderness on the right side of your stomach area (abdomen).
- Lung or breathing problems. Sotorasib may cause inflammation of the lungs that can lead to death. Tell your healthcare provider or get emergency medical help right away if you have new or worsening shortness of breath, cough, or fever.
Your healthcare provider may change your dose, temporarily stop, or permanently stop treatment with sotorasib if you develop side effects.
These are not all the possible side effects of sotorasib. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects to Amgen at 1-800-772-6436 (1-800-77-AMGEN).
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Before taking
Before taking sotorasib, tell your healthcare provider about all your medical conditions, including if you:
- have liver problems.
- have lung or breathing problems other than lung cancer.
- are pregnant or plan to become pregnant. It is not known if sotorasib will harm your unborn baby.
- are breastfeeding or plan to breastfeed. It is not known if sotorasib passes into your breast milk. Do not breastfeed during treatment with sotorasib and for 1 week after the last dose.
How should I take sotorasib?
Take sotorasib exactly as your healthcare provider tells you to take it. Do not change your dose or stop taking this medicine unless your healthcare provider tells you to.
- Take your dose of sotorasib 1 time each day, at the same time each day.
- Take sotorasib with or without food.
- Swallow the tablets whole. Do not chew, crush, or split tablets.
For colon or rectal cancer, you will also receive panitumumab through a vein in your arm (intravenously), given by your healthcare provider. You will first take sotorasib before you receive your first dose of panitumumab. Your healthcare provider will temporarily or permanently stop your treatment with panitumumab if your treatment with sotorasib is temporarily or permanently stopped.
If you cannot swallow sotorasib tablets whole:
- Place your prescribed dose of sotorasib in a glass of 4 ounces (120 mL) of non-carbonated, room temperature water without crushing the tablets. Do not use any other liquids. Stir or swirl the cup for about 3 minutes until the tablets are in small pieces (the tablets will not completely dissolve). The color of the mixture may be pale yellow to bright yellow.
- Drink the sotorasib and water mixture right away or within 2 hours of preparing. Do not chew pieces of the tablet.
- Rinse the glass with an additional 4 ounces (120 mL) of water and drink to make sure that you have taken the full dose of sotorasib.
- If you do not drink the mixture right away, stir or swirl the mixture again before drinking.
If you take an antacid medicine, take sotorasib either 4 hours before or 10 hours after the antacid.
If you vomit after taking a dose of sotorasib, do not take an extra dose. Take your next dose at your regularly scheduled time the next day.
What happens if I miss a dose?
If you miss a dose of sotorasib, take the dose as soon as you remember. If it has been more than 6 hours, do not take the dose. Take your next dose at your regularly scheduled time the next day. Do not take 2 doses at the same time to make up for a missed dose.
What other drugs will affect sotorasib?
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, dietary, and herbal supplements. Sotorasib can affect the way some other medicines work, and some other medicines can affect the way sotorasib works.
Especially tell your healthcare provider if you take antacid medicines, including Proton Pump Inhibitor (PPI) medicines or H2 blockers during treatment with sotorasib. Ask your healthcare provider if you are not sure.
How should I store sotorasib?
Store sotorasib at room temperature between 68°F to 77°F (20°C to 25°C).
- The bottle has a child-resistant closure.
- Keep out of the reach of children.
Ingredients
Active Ingredient: sotorasib
Inactive Ingredients: microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, and magnesium stearate. Tablet film coating material contains polyvinyl alcohol, titanium dioxide, polyethylene glycol, talc, iron oxide yellow, and iron oxide red (320 mg tablet only).
Manufacturer
Sotorasib is made by Amgen Inc., under the brand name Lumakras. Amgen is located in Thousand Oaks, CA 91320-1799, U.S.A.
Popular FAQ
How effective is Lumakras, what's the survival rate?
In one clinical study with Lumakras, 45 out of 124 people (36%) saw their non-small cell lung cancer (NSCLC) tumors disappear or decrease in size by at least 30%. The median duration of response was 10 months. In another lung cancer study, the 12-month progression-free survival rate was 24.8% with Lumakras vs. 10.1% with the chemotherapy agent docetaxel. Continue reading
References
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- Drug class: miscellaneous antineoplastics
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